Association of Habitual Dietary Fiber Intake and Fecal Microbiome Gene Abundance with Gastrointestinal Symptoms in an Irritable Bowel Syndrome Cohort

Abstract Objectives Dietary fibre supplementation is recognised as important for functional gastrointestinal disorders (FGID). The exact role of the microbiome in this relationship remains unclear. We explored differences in dietary fibre intake, GI symptoms and the fecal microbiome in those with FGID. Methods The COMFORT cohort is an observational case control study examining FGID, particularly irritable bowel syndrome (IBS) aetiology (Ethics 16/NTA/21). Participants prospectively completed a food and GI symptoms diary over 3 days. Severity of GI symptoms and mood disorders were assessed using clinical questionnaires; SAGIS and PROMIS for GI symptoms and HADS for anxiety and depression. Fecal samples were analysed by shotgun sequencing; 95 healthy controls (HC), 22 constipation IBS (IBS-C) and 50 diarrhea IBS (IBS-D). Taxonomic classifications were assigned by aligning sequences against the NCBI non-redundant database using DIAMOND. Results Diet diaries were completed by 292 participants (176 cases, 71.2% female). Average daily fibre intake was higher in HC compared to FGID (23.99g, 95% CI = –2.06-0.55; 20.28g, 95% CI = -1.96-0.45; P < 0.05). Low fibre daily intake (< 15g) was associated with higher depression scores (P < 0.05) and increased anxiety in those with functional diarrhea (r2 = -0.554, P = 0.03). A negative association between fibre consumption and increased bloating in IBS (r2 = -0.19, P = 0.04) was also found. The GI microbiome in IBS was characterised by differences in Firmicutes belonging to the Lachnospiraceae family (e.g., Blautia and Ruminococcus, P < 0.05). Other differentiating taxa included Bilophila (higher in IBS-D) and Methanobrevibacter (lower in IBS-D) (P < 0.05). At the phylum level, bloating and constipation were correlated with Firmicutes relative abundance, and negatively correlated with Bacteroides (canonical r > |0.5|). At the genus level, Blautia were correlated with diarrhea and faecal incontinence (canonical r > 0.5). Conclusions Higher fibre consumption was associated with decreased bloating, anxiety and depression in different FGID subgroups. IBS was also associated with altered fecal microbiome composition including some taxa linked to carbohydrate and hydrogen metabolism. Funding Sources Funded by the Ministry of Business, Innovation and Employment through the High-Value Nutrition National Science Challenge.

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Gastrointestinal Symptoms in Diabetes Occur Long Before Diabetic Complications

10.21203/rs.3.rs-594914/v1 ◽

2021 ◽

Author(s):

Hwanseok Jung ◽

Eun-Jung Rhee ◽

Mi Yeon Lee ◽

Jung Ho Park ◽

Dong Il Park ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Functional Dyspepsia ◽

Diabetes Complications ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Gastrointestinal Disorders ◽

Gi Symptoms ◽

Irritable Bowel ◽

Diabetes Patients

Abstract Background: Gastrointestinal (GI) manifestations are common in patients with diabetes complications such as autonomic neuropathy. However, the prevalence of GI symptoms before the development of diabetes complications remains unclear.Method: We performed an interview survey of functional gastrointestinal disorders in diabetes patients who visited the endocrinology clinic of a general hospital using the ROME III criteria. The investigation consisted of various questions on functional dyspepsia, irritable bowel syndrome, and functional constipation including functional defecation disorder.Results: A total of 509 patients were included in this analysis. The patients were analyzed in three groups, prediabetes patients (n = 115), diabetes patients without neuropathy (n = 275), and diabetes patients with neuropathy (n = 119). The prevalence of gastrointestinal symptoms in prediabetes patients, diabetes patients without neuropathy, and diabetes patients with neuropathy was estimated at 16.52%, 27.27%, and 23.53% for functional dyspepsia; 8.7%, 11.68%, and 16.81% for irritable bowel syndrome; and 8.85%, 11.85%, and 15.25% for functional constipation. In the subgroup analysis, postprandial distress syndrome symptoms such as postprandial fullness and early satiation were more prevalent than epigastric pain symptoms. In the constipation group, pelvic outlet obstruction symptoms such as the sensation of anorectal obstruction or blockage and manual maneuvers to facilitate defecation were more frequently observed than slow transit constipation symptomsConclusions: The prevalence of functional gastrointestinal disorders increased with diabetes severity. Diabetes-related GI symptoms appeared long before the diabetes complications

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Impact of Opioid Consumption in Patients With Functional Gastrointestinal Disorders

Frontiers in Pharmacology ◽

10.3389/fphar.2020.596467 ◽

2020 ◽

Vol 11 ◽

Author(s):

Chloé Melchior ◽

Charlotte Desprez ◽

Fabien Wuestenberghs ◽

Anne-Marie Leroi ◽

Antoine Lemaire ◽

...

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Functional Dyspepsia ◽

Functional Gastrointestinal Disorders ◽

Opioid Consumption ◽

University Hospital ◽

Gastrointestinal Disorders ◽

Gi Symptoms ◽

Irritable Bowel

Objective: We aimed to determine the burden of opioid consumption in a cohort of patients with functional gastrointestinal disorders.Methods: All patients diagnosed with functional gastrointestinal disorders and referred to our university hospital were evaluated from 2013 to the beginning of 2019. Irritable bowel syndrome and functional dyspepsia diagnoses were determined according to Rome criteria and severity according to irritable bowel syndrome severity scoring system. Vomiting was quantified using a 5-point Likert scale, and constipation severity was measured using the Knowles-Eccersley-Scott-Symptom questionnaires. Quality of life was quantified by the GastroIntestinal Quality of Life Index. Patients were categorized as being treated on a chronic basis with either tramadol, step II opioids, step III opioids or as being opioid-free.Results: 2933 consecutive patients were included. In our cohort, 12.5% had only irritable bowel syndrome, 39.3% had only functional dyspepsia, 24.9% had a combination of both, and 23.4% had other functional gastrointestinal disorders. Among them, the consumption of tramadol, step II (tramadol excluded) and step III opioids was 1.8, 1.3 and 0.3 % respectively in 2013 and 4.3, 3.4 and 1.9% in 2018 (p < 0.03). Opioid consumption was associated with increased vomiting (p = 0.0168), constipation (p < 0.0001), symptom severity (p < 0.001), more altered quality of life (p < 0.0001) and higher depression score (p = 0.0045).Conclusion: In functional gastrointestinal disorders, opioid consumption has increased in the last years and is associated with more GI symptoms (vomiting, constipation and GI severity), higher depression and more altered quality of life.

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Irritable bowel syndrome: towards an integrated approach

Health SA Gesondheid ◽

10.4102/hsag.v4i1.12 ◽

1999 ◽

Vol 4 (1) ◽

pp. 45-46 ◽

Cited By ~ 1

Author(s):

Anita D Stuart ◽

H Gertie Pretorius ◽

Lynette Van der Merwe

Keyword(s):

North Carolina ◽

Irritable Bowel Syndrome ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Integrated Approach ◽

Gastrointestinal Disorders ◽

University Of North Carolina ◽

Irritable Bowel ◽

The Impact

Functional Gastrointestinal Disorders are defined as chronic or recurrent gastrointestinal symptoms characterized by abdominal pain, constipation and/or diarrhoea (Tally, 1994; University of North Carolina, 1998). These disorders are of concern because of their high incidence, associated morbidity, expense and the impact of these disorders on people's quality of life. Drossman (1993, in University of North Carolina (UNC), 1998) found that of 5 400 U.S. households, 69% of people met the criteria for at least one of the functional gastrointestinal disorders which represents a 59% increase in the incidence of functional gastrointestinal disorders since 1983 (Drossman, in UNC, 1998; Drossman, 1983). In particular, Irritable Bowel Syndrome (IBS) sufferers account for 2,4 - 3,5 million visits to doctors annually. Furthermore, IBS sufferers spend $40 million annually on treatment for their condition. They also tend to have 3 to 4 times more disability days than other workers, which illustrates the debilitating effect of this disorder (Drossman, in UNC, 1998). It is therefore necessary that the etiology of IBS be researched, as well as the course and management of this debilitating disease. The studies presented in this series aimed to improve the understanding of the multiple agents that influence the development and course of IBS.

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The Therapeutic Effect of a Multistrain Probiotic on Diarrhea-Predominant Irritable Bowel Syndrome: A Pilot Study

Gastroenterology Research and Practice ◽

10.1155/2018/8791916 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Seok-Hoon Lee ◽

Nam-Seok Joo ◽

Kwang-Min Kim ◽

Kyu-Nam Kim

Keyword(s):

Irritable Bowel Syndrome ◽

Statistical Significance ◽

Information Service ◽

Gastrointestinal Symptoms ◽

Bacterial Overgrowth ◽

Fecal Calprotectin ◽

Beneficial Bacteria ◽

Research Information ◽

Fecal Microbiome ◽

Irritable Bowel

Backgrounds. Recent studies suggest that diarrhea-predominant irritable bowel syndrome (IBS) is associated with intestinal bacterial microflora, colonic inflammation, and small intestinal bacterial overgrowth (SIBO). The purpose of this study was to evaluate the effect of a multistrain probiotic intake on these associated factors in patients with diarrhea-predominant IBS. Methods. The recruited volunteers were adults who were diagnosed with diarrhea-predominant IBS according to the Rome III criteria. After 8 weeks of probiotic ingestion, changes in gastrointestinal symptoms, fecal microbiome, SIBO, and fecal calprotectin were determined. Results. There was an increase in beneficial bacteria (41.2 ± 16.8% vs. 53.7 ± 15.3%, P=0.018) and a decrease in harmful bacteria (13.0 ± 13.9% vs. 4.7 ± 4.0%, P=0.010) in the microbial stool analysis. The SIBO prevalence also decreased at the end of treatment. However, the average levels of fecal calprotectin showed a decreasing tendency, without reaching statistical significance (364.4 ± 729.1 mg/kg vs. 200.9 ± 347.6 mg/kg, P=0.375). Conclusion. Treatment with a multistrain probiotic for 8 weeks led to significant increases in beneficial bacteria in the gut as well as the improvement of gastrointestinal symptoms. This study is registered at the Clinical Research Information Service (KCT0002906).

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Low-FODMAP Diet and Its Role in Irritable Bowel Syndrome (IBS) Management

Proceedings of The Nutrition Society ◽

10.1017/s0029665120000956 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Fábio Cardoso ◽

Mónica Azevedo ◽

Bruno Oliveira ◽

Rui Poínhos ◽

João Carvaho ◽

...

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Emotional Disorders ◽

Depression Scale ◽

Anxiety And Depression ◽

Inverse Association ◽

Restricted Diet ◽

Gi Symptoms ◽

Irritable Bowel

AbstractIntroductionIrritable Bowel Syndrome (IBS) is a functional and multifactorial gastrointestinal disorder characterized by pain, abdominal distention and motility changes, currently diagnosed based on the Rome IV criteria. The efficacy of classic pharmacological, psychological and dietary treatments for this condition are generally low. The Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAP) are short chain carbohydrates poorly absorbed at the intestinal level, fermentable by the microbiota and presumably involved in IBS-associated symptomatology.AimsTo evaluate the efficacy, feasibility and acceptability of a FODMAP-restricted feeding approach in the relief of symptomatology and in the improvement of the quality of life of patients with IBS, determining the reintroduction of the FODMAP food subgroup(s) involved in the symptom exacerbation.Materials and MethodsAfter assessing the existence of initial emotional disorders through the Hospital Anxiety and Depression Scale (HADS) and eating habits, through dietary history, patients diagnosed with IBS were put on a FODMAP-restricted diet for 6 weeks. During this period, the weekly evolution of symptom frequency was assessed. At the end, tests were undertaken to discover the global evolution of the symptoms through the Irritable Bowel Syndrome - Global Assessment Scale (IBS-GAI), the severity of symptomatology through the Irritable Bowel Syndrome - Severity Scoring System (IBS-SSS) and quality of life through Irritable Bowel Syndrome - Quality of Life (IBS-QoL).Subsequently, participants tested their tolerance to various FODMAP subtypes with weekly and isolated reintroduction of these in their diet.ResultsIn the 36 participants, with a mean age of 38.8 years, there was a reduction in the total consumption of FODMAP from 22.1 g to 2.1 g (p < 0.001). A moderate or substantial improvement in the IBS-GAI was observed in 88.9%. An average reduction of 235 points in the IBS-SSS (p < 0.001) and a mean increase of 28.7 in the IBS-QoL (p < 0.001) was achieved. The initial anxiety and depression levels were not associated with IBS-SSS and presented an inverse association with the IBS-QoL. There was significant improvement in all symptomatology during the 1st week of total FODMAP restriction, except for constipation with an amelioration observed at the 6st week. There was a frequency of intolerance ranging from 30.8% for fructans to 80.8% for lactose with the reintroduction of the FODMAP subtypes.ConclusionA FODMAP-restricted diet, implemented over a period of 6 weeks, is effective in reducing the severity and frequency of GI symptoms and improving the quality of life of portuguese patients with IBS.

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Comparison of Laughter Yoga and Anti-Anxiety Medication on Anxiety and Gastrointestinal Symptoms of Patients with Irritable Bowel Syndrome

Middle East Journal of Digestive Diseases ◽

10.15171/mejdd.2019.151 ◽

2019 ◽

Vol 11 (4) ◽

pp. 211-217 ◽

Cited By ~ 1

Author(s):

Tahmine Tavakoli ◽

Navid Davoodi ◽

Toktam Sadat Jafar Tabatabaee ◽

Zeinab Rostami ◽

Homa Mollaei ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Gastrointestinal Symptoms ◽

Symptomatic Treatment ◽

Control Group ◽

Controlled Clinical Trial ◽

Yoga Group ◽

Gi Symptoms ◽

Before And After ◽

The Difference ◽

Irritable Bowel

BACKGROUND Irritable bowel syndrome (IBS) is the most common chronic gastrointestinal (GI) disorder. Patients with IBS usually suffer from anxiety and depression. A combination of psychological approaches and pharmacological treatments can be a significantly effective treatment for IBS. The main objective of the present study was to provide a therapeutic plan based on laughter yoga and anti-anxiety medication, employed for the very first time, and to determine the effectiveness of these treatments on the anxiety and GI symptoms of patients with IBS. METHODS In this randomized, controlled, clinical trial, the participants were 60 patients selected from those who referred to the GI clinic of Vali-asr Hospital (Birjand, Iran) during the study period (April 2017 to March 2017) and were diagnosed as having IBS based on ROME III criteria. The participants were randomly assigned to either the laughter yoga group, the anti-anxiety medication group, or the symptomatic treatment (control) group. Severity levels of anxiety and GI symptoms before and after intervention were determined and compared among these three groups according to approved protocols. RESULTS The severity of IBS symptoms after the interventions was more greatly reduced in the laughter yoga group than in the anti-anxiety medication and control groups (p = 0.006). The severity of anxiety after interventions decreased in all three groups, especially in the yoga treatment group, but the difference was not statistically significant (p = 0.1). CONCLUSION Laughter yoga is more effective than anti-anxiety medication in reducing the GI symptoms of patients with IBS. Therefore, applying laughter yoga along with common pharmacological therapies for patients with IBS might be strongly advised.

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COGNITION AND THE BODY: SOMATIC ATTRIBUTIONS IN IRRITABLE BOWEL SYNDROME

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465803001036 ◽

2003 ◽

Vol 31 (1) ◽

pp. 13-31 ◽

Cited By ~ 9

Author(s):

Maryanne Martin ◽

Catherine Crane

Keyword(s):

Irritable Bowel Syndrome ◽

Attributional Style ◽

Gastrointestinal Symptoms ◽

The Body ◽

Anxiety And Depression ◽

Treatment Seeking ◽

Considerable Proportion ◽

Physiological Symptoms ◽

Irritable Bowel ◽

Treatment Seekers

How do somatic causal attributions for symptoms relate to treatment seeking behaviour in Irritable Bowel Syndrome (IBS)? How might a tendency to make somatic attributions influence an individual's cognitive representation of their illness once a diagnosis of IBS is established? In Study 1 attributions about symptoms were investigated in treatment-seekers and non treatment-seekers with IBS. Treatment-seekers had an increased tendency to make somatic attributions for both gastrointestinal symptoms and physiological symptoms characteristic of anxiety and depression, although they did not differ from non treatment-seekers in the severity of these symptoms or in their reports of psychological distress. Treatment-seekers also perceived themselves to be significantly less resistant to illness and to be significantly more likely to have poor health in the future than non treatment-seekers. In Study 2, 20 treatment seekers with chronic symptoms of IBS completed measures of mood and of the degree to which they viewed a range of symptoms as a part of their IBS. Physiological symptoms of anxiety and depression were seen as a part of IBS by a considerable proportion of the sample. Higher levels of depression were associated with an increased tendency to see physiological symptoms of anxiety and depression and even symptoms of colds as “a part of” IBS. It is concluded that a somatic attributional style may contribute both to initial treatment seeking for symptoms of IBS and the subsequent maintenance and exacerbation of the disorder once a diagnosis is established.

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Subthreshold Psychiatric Psychopathology in Functional Gastrointestinal Disorders: Can It Be the Bridge between Gastroenterology and Psychiatry?

Gastroenterology Research and Practice ◽

10.1155/2017/1953435 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 9

Author(s):

Cristina Stasi ◽

Cristiana Nisita ◽

Sonia Cortopassi ◽

Giorgio Corretti ◽

Dario Gambaccini ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Functional Dyspepsia ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Psychiatric Evaluation ◽

Gastrointestinal Disorders ◽

Axis I ◽

Spectrum Disorders ◽

Irritable Bowel

Background and Aims. Functional gastrointestinal disorders (FGDs) are multifactorial disorders of the gut-brain interaction. This study investigated the prevalence of Axis I and spectrum disorders in patients with FGD and established the link between FGDs and psychopathological dimensions.Methods. A total of 135 consecutive patients with FGD were enrolled. The symptoms’ severity was evaluated using questionnaires, while the psychiatric evaluation by clinical interviews established the presence/absence of mental (Diagnostic and Statistical Manual—4th edition, Axis I Diagnosis) or spectrum disorders.Results. Of the 135 patients, 42 (32.3%) had functional dyspepsia, 52 (40.0%) had irritable bowel syndrome, 21 (16.2%) had functional bloating, and 20 (15.4%) had functional constipation. At least one psychiatric disorder was present in 46.9% of the patients, while a suprathreshold panic spectrum was present in 26.2%. Functional constipation was associated with depressive disorders (p<0.05), while functional dyspepsia was related to the current major depressive episode (p<0.05). Obsessive-compulsive spectrum was correlated with the presence of functional constipation and irritable bowel syndrome (p<0.05).Conclusion. The high prevalence of subthreshold psychiatric symptomatology in patients with FGD, which is likely to influence the expression of gastrointestinal symptoms, suggested the usefulness of psychological evaluation in patients with FGDs.

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Irregular Dietary Habits with a High Intake of Cereals and Sweets Are Associated with More Severe Gastrointestinal Symptoms in IBS Patients

Nutrients ◽

10.3390/nu11061279 ◽

2019 ◽

Vol 11 (6) ◽

pp. 1279 ◽

Cited By ~ 6

Author(s):

Clara Nilholm ◽

Ewa Larsson ◽

Bodil Roth ◽

Rita Gustafsson ◽

Bodil Ohlsson

Keyword(s):

Irritable Bowel Syndrome ◽

Dietary Habits ◽

Eating Habits ◽

Gastrointestinal Symptoms ◽

Well Being ◽

Irritable Bowel Syndrome Symptom ◽

Dietary Advice ◽

Blood Levels ◽

Gi Symptoms ◽

Irritable Bowel

Dietary advice constitutes one of the first choices of treatment for irritable bowel syndrome (IBS). We have recognized an increased prevalence of sucrase-isomaltase (SI) gene variants in IBS patients, possibly rendering starch- and sucrose-intolerance. The aims were to examine participants’ dietary habits at baseline, to correlate habits with gastrointestinal (GI) symptoms and blood levels of minerals and vitamins, and to examine the effect of a starch- and sucrose-reduced diet (SSRD) on GI symptoms. In the study 105 IBS patients (82 women, 46.06 ± 13.11 years), irritable bowel syndrome-symptom severity scale (IBS-SSS)>175, were randomized to SSRD for 2 weeks or continued ordinary eating habits. Blood samples, visual analog scale for irritable bowel syndrome (VAS-IBS), IBS-SSS, and 4-day food diaries were collected at baseline and after 2 weeks. Patients with irregular dietary habits exhibited higher IBS-SSS than patients with regular habits (p = 0.029). Women already on a diet had lower ferritin levels than others (p = 0.029). The intervention led to 66.3% of patients being responders, with differences in the change of IBS-SSS (p < 0.001), abdominal pain (p = 0.001), diarrhea (p = 0.002), bloating and flatulence (p = 0.005), psychological well-being (p = 0.048), and intestinal symptoms’ influence on daily life (p < 0.001), compared to controls. Decreased intake of cereals and sweets/soft drinks correlated with decreased scores.

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The Effect of Probiotics on Quality of Life, Depression and Anxiety in Patients with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10163497 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3497

Author(s):

Charlotte Le Morvan de Sequeira ◽

Marie Kaeber ◽

Sila Elif Cekin ◽

Paul Enck ◽

Isabelle Mack

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Meta Analysis ◽

Functional Gastrointestinal Disorders ◽

Cochrane Library ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Irritable Bowel ◽

Meta Analyses

Background: Functional gastrointestinal disorders such as irritable bowel syndrome (IBS) report clinical improvement following probiotic therapy, but whether psychiatric comorbidity and quality-of-life in IBS improves directly or in directly is unknown. This meta-analysis synthesized the evidence regarding the effects of probiotics on quality of life (QoL), anxiety and depression in IBS. Methods: The review was executed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the databases PubMed, Web of Science and Cochrane Library. For QoL, the data were meta-analyzed, and for anxiety and depression a qualitative analysis was performed. Results: Thirty-five placebo-controlled studies were included of which 11 were eligible for meta-analysis. QoL improved with probiotic and placebo similarly, with the probiotic interventions slightly superior (mean QoL difference—0.36 (95% CI: 0.07, 0.64); p = 0.01). Anxiety and depression were similar between placebo and probiotic groups following therapy. Conclusion: For IBS, probiotic therapy improved QoL, but had no effects on anxiety and depression. However, the applied probiotics were not developed for selective effects on psyche and the brain. Therefore, it remains to be shown whether or not patients with IBS would benefit from second generation probiotics developed for these central effects (psychobiotics).

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